Abstract
Previous studies have documented the important association of non-polio enterovirus (E) isolation with SS in young infants. These studies relied on tissue culture alone to identify E. We utilized a double-antibody, solid-phase EIA for CA, in addition to standard methods, in the evaluation of 45 patients <3 months of age admitted to NCMC for SS from 6/1 to 10/31/83. No patient had an obvious focus of infection, abnormal chest roentgenogram, or history of previous antibiotics. 38 patients had a rectal temperature ≥37.8°C on admission, 4 were febrile by history, and 3 were evaluated for lethargy. Blood, cerebrospinal fluid (CSF) and rectal swabs were collected from all patients and urine from 39 for routine bacterial studies. CSF from 42 and nasopharyngeal, throat and rectal swabs from all patients were plated on rhesus monkey and human embryonic kidney cells for viral isolation. Echovirus (8), coxsackie-virus (10), untyped E (2) and parainfluenza (1) were identified by culture and CA antigen was detected in an additional 5 patients. All of the 26 patients with proven viral infections were suspected of having bacterial infections on clinical grounds and 25 were treated with anitbiotics despite negative bacterial cultures. These data support a major role for E in SS in the summer and fall. Further evaluation of rapid diagnostic tests for viruses and their role in preventing unnecessary antibiotic administration are warranted.
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Leggiadro, R., Zucker, S., Blinderman, B. et al. 558 COXSACKIE A (CA) ANTIGEN DETECTION BY ENZYME IMMUNOASSAY (EIA) IN SUSPECTED SEPSIS (SS). Pediatr Res 19, 203 (1985). https://doi.org/10.1203/00006450-198504000-00588
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DOI: https://doi.org/10.1203/00006450-198504000-00588